SEARCH · PubMed Health

Results for “Delphi”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources

PubMed2004

[Innovative potentials and new areas of responsibility for nursing in the service sector of the future--results of a Delphi-study in Germany].

Present reforms and dynamics of development within the health care system have led to different health care needs and new demands on nursing. It has been assumed that in the future a number of innovative potentials and new areas of responsibility will develop. Consequently, new nursing services will also come into being which are to be located at the interface of Nursing and Public Health. Adopting the Delphi technique the Institute for Applied Nursing Research at the University of Bremen carried out nation-wide study which was aimed at experts (n = 41) representing research and development, as well as political interests regarding health and nursing-related institutions of the German health care system. Four areas of responsibility were considered most relevant for the development of new nursing services: consultancy/information work, health promotion/prevention/rehabilitation, management and co-ordination/integration/co-operation. The biggest market is expected within the area of consultancy work. The development of those four areas is closely connected with the grade of professionalisation. Additionally, linking Public Health and Nursing will include a change in the way nursing sees itself. Furthermore, nursing objectives and interventions will be altered, too.

Career Choice↗

PubMed2000

Delphi-panel analysis of appropriateness of high-dose chemotherapy and blood cell or bone marrow autotransplants in women with breast cancer.

BACKGROUND: There is controversy whether high-dose chemotherapy and a blood cell or bone marrow autotransplant is a better treatment than conventional-dose chemotherapy for women with local/regional or metastatic breast cancer. Subject selection and time-to-treatment biases make definitive comparison impossible. Recent results of randomized trials are contradictory. OBJECTIVE: Determine appropriateness of high-dose chemotherapy and a blood cell or bone marrow autotransplant in women with breast cancer. PANELISTS: Nine breast cancer experts from diverse geographic sites and practice settings. EVIDENCE: Boolean MEDLINE searches of 'breast cancer' and 'chemotherapy' and/or 'blood cell' or 'bone marrow transplants'. PROCESS: We used a modified Delphi-panel group judgement process. Clinical variables were permuted to define 2058 clinical settings. Each panelist rated appropriateness of high-dose therapy and an autotransplant versus conventional therapy on a 9-point ordinal scale (1: most inappropriate, 9: most appropriate). An appropriateness index was developed based on median rating and amount of disagreement. The relationship of appropriateness indices to the permuted clinical variables was considered by analysis of variance and recursive partitioning. CONCLUSIONS: In women with local/regional breast cancer autotransplants were rated: 1) appropriate in those with > or = 10 cancer-involved lymph nodes; 2) uncertain in those with 4-9 cancer-involved nodes; and 3) inappropriate in women with < or = 3 cancer-involved lymph nodes. In women with metastatic breast cancer autotransplants were rated: 1) appropriate in those with metastases to 'favorable' sites (skin, lymph node, pleura) and a complete or partial response to chemotherapy; 2) uncertain in women with metastases to 'unfavorable' sites (lung, liver, or central nervous system) and a complete response to chemotherapy or those with bone metastases and a complete or partial response or stable disease after chemotherapy; and 3) inappropriate in other settings.

Antineoplastic Agents↗

PubMed2002

What knowledge and skills are essential for specialists in Clinical Pharmacology and Therapeutics? Results of a Delphi study.

AIMS: To identify the knowledge and skills that should be considered essential for specialists in Clinical Pharmacology and Therapeutics (CPT) with a commitment to the National Health Service (NHS). METHODS: A Delphi study using a sample of current specialists. RESULTS: Members of the expert panel (20 in all, representative of the Clinical Section membership) identified 78 statements for consideration, in four domains (core of knowledge, therapeutic skills, educative skills, and investigative skills), of which 58 (74.4%) were accepted by more than two-thirds of respondents. Of these, 35 were knowledge items, whereas 23 were skills (11 therapeutic, 4 educative and 8 investigative). The large majority (79.3%) of these statements were endorsed by at least four out of five panel members. CONCLUSIONS: Despite the varied work patterns and responsibilities of specialists in CPT, it is possible to identify a core of knowledge and skill that most consider essential for the delivery of their commitment to the NHS. The findings will provide NHS Trusts with a clear idea of what they can expect from these specialists, and will act as a checklist for specialists themselves to direct their Continuing Professional Development within the consultant appraisal process. The results also describe a curriculum for continuing education in CPT, which the BPS Clinical Section can use to develop information resources and training opportunities.

Clinical Competence↗

PubMed2002

Perceptions of the quality of life for the adolescent with a chronic illness by teachers, parents and health professionals: a Delphi study.

AIMS: The perceptions that teachers, parents and health professionals have on the relative importance of different aspects of quality of life (QOL) for the adolescent with a chronic illness were explored using a three-round Delphi study. METHODS: The first round questionnaire identified the level of importance each panel attached to 16 aspects relating to QOL. Panellists were also encouraged to provide additional comments on why they felt a particular item was important. In round two, panellists were asked to prioritize the items in order of importance, whereas round three attempted to achieve consensus among each of the three panels. RESULTS: Differences between and within panels in the prioritization of items in round one and round two were evident. However, consensus was achieved in round three, except for the prioritization of very important items by the panel of teachers. Items identified by all three panels as extremely important included the adolescent's attitude, family relationships and friendships with the same age group. Themes to emerge from the qualitative responses to the open-ended questions included the perception of the chronically ill adolescent 'not wanting to be different' and the importance of a 'positive attitude'. The majority of participants also perceived adolescents with a chronic illness as having worse QOL than their healthy counterparts. CONCLUSIONS: By increasing the awareness among the different groups of the impact of chronic illness on various aspects of adolescent QOL, the overall care and support of those adolescents could be improved. Further studies should also be undertaken to explore the views of the chronically ill adolescents themselves.

Adolescent↗

PubMed1999

A Delphi survey of research priorities and identified areas for collaborative research in health sector library and information services UK.

The survey aims were to determine research priorities in the Health Library and Information Services sector in the United Kingdom as to their perceived value for the professional and impact on user needs and to identify areas suitable for collaborative research. A 34-member panel consisting of the Chairs of professional groups, journal editors, educationalists, key organizations and representatives from the Health Libraries Group, Libraries for Nursing and University Health Science Libraries professional groups, participated in a three-round postal questionnaire survey using the Delphi Technique. Consensus was achieved for a final set of 20 research priorities. The priorities and their category groups are discussed in the context of (i) the current R&D scene, and (ii) the health information environment. Six developmental recommendations are provided.

Cooperative Behavior↗

PubMed1993

The emerging role of the British nurse teacher in Project 2000 programmes: a Delphi survey.

The findings of a three-round Delphi survey, conducted to explore the role of the British nurse teacher as it emerges within Project 2000 programmes, are discussed. The panel of experts comprising 201 grade 2 nurse teachers was drawn from the 25 of the 28 colleges in England who had implemented Project 2000 between September 1989 and April 1991. The findings highlight the complex and multifaceted role of the nurse teacher and the changes which are occurring in the role. Currently, the main changes are related to teaching and learning activities. These emphasize the depth, level and specialist nature of the teaching, and teaching on a variety of courses at diploma and degree level. Assessment activities are given the highest overall rating as important, and recruitment activities the lowest, in both the current and future roles. Educational management and administrative activities are found to be numerous and currently do not appear to be declining. The few changes that have occurred to the administrative areas have been replaced with similar activities. Another important area for the future was perceived to be research activity. In view of the developing partnership with higher education in the United Kingdom, this is not a surprising finding.

Delphi Technique↗

PubMed1997

Studying the future: a Delphi survey of how multi-disciplinary clinical staff view the likely development of two community mental health centres over the course of the next two years.

Two community mental health centres (CMHCs) in North Staffordshire, England were the sites for a recent Delphi survey of multi-disciplinary clinical staff. The views of staff were sought on the likely developments over the next 2 years, at the CMHC where they worked. Each group of staff independently produced healthy numbers of suggestions, with few contradictions; and displayed predominantly positive attitudes, both towards particular suggestions and the future in general. Summarized results were classified within seven themes, producing similar distribution patterns for both CMHCs. The most frequently occurring themes were changing staff roles and CMHC functions and developments in therapies and skills. Mid-placed themes concerned community development and communication/continuity. The least frequently reported themes covered general management, user involvement and quality assurance. Issues raised by the study are discussed and related to other published works, followed by consideration of how the findings might be utilized. Clinical staff have generated a large number of suggestions and, importantly, via rounds of confidential voting, indicated the group consensus on each item. Consequently, management of change should stand a high chance of success. Finally, one means of taking the findings forward is described.

Attitude of Health Personnel↗

PubMed2001

Identification of priorities for nursing research in Spain: a Delphi study.

AIM: The aim of this work was to identify priorities for nursing research in Spain. The Co-ordination and Development of Nursing Research Centre (Investén-isciii group) carried out the study using the Delphi technique during the period April 1998 to January 1999. METHODS: Study subjects were professionals involved in different nursing activities. From 1250 eligible professionals initially contacted, 452 (38%) responded in round 1 and 258 (57%) in round 2. But only 189 filled out correctly the questionnaires from both rounds of data collection (overall response rate was 21.6%). RESULTS: The participants identified priorities related to continuity and co-ordination of nursing care, quality of nursing care, impact of invasive techniques and treatments on the quality of life of patients, needs of the primary care givers, quality of life among elders, satisfaction of customers and needs of terminal patients and their families.

Adult↗

PubMed2003

The Delphi technique: myths and realities.

AIMS: To outline the key concepts and principles of the Delphi technique. METHODS: Reference is made to a selection of studies that illustrate a variety of methodological interpretations. Drawing on Heshusius's concept of 'goodness criteria', particular emphasis is given to the question of scientific merit and means of evaluation. CONCLUSIONS: Although the technique should be used with caution, it appears to be an established method of harnessing the opinions of an often diverse group of experts on practice-related problems.

Consensus↗

PubMed2003

Identifying cancer nursing research priorities using the Delphi technique.

BACKGROUND: Nursing research is an integral component of improving the care of people with cancer. However, for research to be successfully integrated and applied to practice, ownership and identification must come from those in practice. The need for local and national strategies for cancer nursing research and the importance of establishing priorities for cancer nursing research have been repeatedly acknowledged. STUDY AIM: The aim of the study was to facilitate a strategic approach to cancer nursing research by identifying the research priorities of cancer nurses. RESEARCH METHOD: A three-round Delphi survey was administered to nurses (n = 112) attending a cancer nursing research conference in Northern Ireland. Participants were asked to identify five research questions that they considered a high priority for cancer nursing. A response rate of 54% (60 delegates) was obtained for round one and this generated 117 statements. These statements were content analysed. Two subsequent quantitative rounds followed this. RESULTS: The top priority areas identified were psychosocial issues, for example communication and information needs; professional issues relating to nurse burnout, stress and nurse-led care; and context of care issues including continuity of care. LIMITATIONS: A potential limitation of the study is the use of conference delegates. However, it is argued that these are the people we wanted to target as they could be considered as experts who already had an interest and clinical background in both cancer research and practice. CONCLUSION: These priorities have helped to provide both direction and focus for the development of a cancer nursing research strategy for Northern Ireland. It is recommended that future research questions should be focused around the highest ranked priorities.

Adult↗

PubMed2003

The ideal attributes of chief nurses in Europe: a Delphi study.

BACKGROUND: Policy decisions to advance the role of Chief Nurse in member countries of the World Health Organization European Region will necessitate the systematic selection and recruitment of suitable postholders who can develop the role and status of nursing within a wide range of political frameworks and structures. Such posts are clearly of great importance for providing appropriate care through strategic and policy decisions, both nationally and internationally. The appointment and development of suitable personnel are, therefore, essential elements in the success of these roles. To date, no information exists about the qualities and attributes required for effective delivery of the Chief Nurse role. AIM: To identify the characteristics considered to be most relevant in a Chief Nurse, in order to inform and systematize recruitment. METHOD: A Delphi study was undertaken of 22 European member states. Consensus was reached by the second round, in which 12 countries participated. RESULTS: Sixteen relevant qualities were identified and listed in order of importance. Of the eight countries for which statistical analysis was possible, seven demonstrated a significant level of accord [Belgium, Denmark, the Netherlands, the United Kingdom (UK), Iceland, Sweden, Hungary and Switzerland], with only Finland showing no intra-country agreement. CONCLUSIONS: To the extent that there is a high level of inter and intra-country consensus on the desirable qualities of Chief Nurses, these could be used to inform the future systematic selection and operational development of this role in European member states.

Delivery of Health Care↗

PubMed2003

Nurse practitioner practice and deployment: electronic mail Delphi study.

BACKGROUND: The nature of modern government and needs of policy-makers demand accurate information that is delivered quickly. This study was part of a larger project for the Department of Health relating to nurse practitioner (NP) education and practice in UK. AIMS: The aim of the study was to identify the principal factors that help or hinder the development of NP roles in the National Health Service. METHODS: In order to facilitate a rapid response, a Delphi study was undertaken using electronic mail (e-mail) and was completed within 4 weeks. Key stakeholders in NP practice, education and research and (non-governmental) policy-making were invited to participate. Key themes relating to the deployment and practice of NPs were generated. These were refined and collated by the research team and then rated by the respondents. RESULTS: This approach generated valuable expert consensus data around NP deployment and practice. Nurse practitioners' practice is recognized as an integral part of health care that needs to be recognized by regulatory bodies to promote understanding of their potential at local levels. Nurse practitioners need freedom to innovate, adequate support and appropriate education to allow true autonomy. Limited prescribing and local restrictions on requesting investigations hinder practice. LIMITATIONS: Although this was a small-scale study, the expert panel was wide-ranging and achieved substantial consensus. CONCLUSION: The organisational and cultural changes that are required to foster the development of practice and deployment of NPs have yet to be instigated, according to the comments of the key stakeholders in this study. There appears to be a clear message that the government needs to take a more interventionist role in supporting nursing developments, rather than leaving this to local arrangements.

Delphi Technique↗

PubMed1998

Using the Delphi technique to identify the content and context of nurses' continuing professional development needs.

In order to identify and prioritize the development needs of medical and surgical nurses, their possible approaches to learning, and the contextual factors influencing their professional development, a Delphi survey was carried out using a panel of 28 participants. Current development needs included skills in essential clinical care, specialist nursing, changing roles, patient care management, research and practice development. Although there was ambivalence about changing nurses' clinical roles, participants expected roles to diversify in the future. The need for responsiveness to change was emphasized, as was the need to maintain current areas of expertise. Professional development activity could take many forms, but fostering an organizational climate in which development was inherent in everyday working practices was felt to be as valuable as formal course attendance. Restricting factors included lack of time, resources, support and recognition. The survey has enabled professional and practice development activities to be prioritized locally, and the method used could be readily applied to other settings.

Attitude of Health Personnel↗

PubMed2001

Clinical role clarification: using the Delphi method to establish similarities and differences between nurse practitioners and clinical nurse specialists.

This article is based on the Department of Health's (England) funded pluralistic evaluation of Nurse Practitioner preparation, 'Realizing Specialist & Advanced Nursing Practice: establishing the parameters of and identifying competencies for "Nurse Practitioner" roles and evaluating programmes of preparation' (RSANP). During this 27-month project, which began in 1996, one of the research methods used, the Delphi study, was aimed at reaching a consensus of views amongst nurses in clinical practice, educators, purchasers, providers and representatives of statutory and professional bodies on the parameters and competencies desirable for the Nurse Practitioner role. The agreed competencies were then used as one measure of the appropriateness of various programmes used to prepare Nurse Practitioners. Of the competencies required for the role, the majority are 'nursing' competencies and are the same as those required for the Clinical Nurse Specialist role. However, for both Clinical Nurse Specialists and Nurse Practitioners, these are practised at a 'higher level'. Other competencies needed for the Nurse Practitioner role relate to the knowledge and skills required to assess, diagnose and determine nursing and medical management of a patient and to evaluate that management. Data indicated, however, that even these competencies were being used by some Clinical Nurse Specialists. Final analysis enabled the identification of the two roles with the use of a 'Typology of Named Clinical Nursing Roles'.

Attitude of Health Personnel↗

PubMed1999

A Delphi technique to identify and evaluate criteria for construction of PBL problems.

INTRODUCTION: In the process of PBL implementation, faculty members often ask what are the criteria for constructing problems and subsequently evaluating them. Although experts agree on a fundamental theoretical basis for developing problems, mostly prototypical, it is difficult to find specific criteria that could be used in constructing PBL problems. METHOD: A Delphi technique using six independent judges from the Rouen School of Medicine, France, answered this question. It took four rounds and five months. RESULTS: Nine criteria were identified and rank-ordered according to their relative importance: 1. stimulating thinking, analysis, and reasoning (openness 6.8 points); 2. assuring self-directed learning (autonomy 6.5); 3. using previous basic knowledge (richness 6.2); 4. proposing a realistic context (attractiveness 5.7); 5. leading to the discovery of learning objectives (coverage 5.0); 6. arousing curiosity (inquisitiveness 5.0); 7. choosing topics related to public health (relevance 5.0); 8. assuring contextual breadth (comprehensiveness 4.8); and 9. choosing an appropriate vocabulary (medical encoding 4.7). DISCUSSION: The identification represents a fresh outlook on the PBL process, from judges who had recent experience in constructing PBL problems. Related to Barrow's dimensions, these criteria could be seen as a more concrete and specific level of conceptualization. Paired with those found in the literature, they match six out nine already identified, although not prioritized criteria. CONCLUSION: Judges from a school just having implemented PBL, found that Reasoning and Autonomy are the most important criteria for constructing PBL problems.

Delphi Technique↗

PubMed2002

What are the clinical skills levels of newly graduated physicians? Self-assessment study of an intended curriculum identified by a Delphi process.

OBJECTIVE: To compare and contrast the learned and an intended curricula of practical clinical skills across the three Danish medical schools. CONTEXT: The three Danish medical schools had comparable discipline-based curricula with 3 years of mainly basic science and 3(1/2) years of mainly clinical education. Danish physicians work as pre-registration house officers (PRHOs) for 1(1/2) years after graduation. METHODS: An anonymous questionnaire listing 210 practical clinical skills was mailed to 226 newly graduated Danish physicians. They were asked if they could meet the minimum level for each of the skills listed as identified by a previous Delphi study. RESULTS: The response rate was 80%. None of the responders met the minimum of all the 210 skills. Only 8% (14) met the minimum level for at least 90% (189) of the skills. On average the responders met the minimum of 74% (155) of the skills. More than 90% of the responders mastered basic history and examination skills. The responders did not meet 28 medical emergency procedures. CONCLUSIONS: We found that the learned curriculum of clinical skills constituted 75% of the intended curriculum. Those responsible for pre- and postgraduate medical education should be aware of the discrepancy between expected and learned curriculum. We discuss the role of experts in the process of defining the core curriculum.

Clinical Competence↗

PubMed2002

Developing benchmark inventories to assess the content of telephone consultations in accident and emergency departments: use of the Delphi technique.

The provision of telephone advice to members of the general public from staff based in accident and emergency departments is common practice. However, it is largely conducted on an ad hoc basis without the use of formal guidelines or decision support. The evidence base from which to derive guidelines for the telephone assessment and advice of many common conditions is lacking. This study, using the Delphi technique, was undertaken to develop a number of benchmarks for use as objective measures against which the comprehensiveness of telephone assessments could be tested. Consensus views on the essential and desirable items to be considered for each of 10 presenting complaints was achieved. It is argued that establishing consensus views on clinical topics provides an effective means of developing an evidence base where other sources of evidence are lacking.

Benchmarking↗

PubMed2000

The required role of the psychiatric-mental health nurse in primary health-care: an augmented Delphi study.

An augmented Delphi study was employed to elicit the perceptions of CPNs, GPs, social workers, managers of psychiatric nursing services and health service purchasers in England, on the role required of a psychiatric (mental health) nurse in primary health care. In the final stage of the study, users of mental health service were enlisted in a verification study of the emergent findings. A broad consensus emerged that a gap existed in mental health services in primary care. This was perceived as placing a large burden on GPs, which might be reduced by the appropriate development of community psychiatric-mental health nursing. The study suggested the possibilities for development of a 'mental health nurse consultant' role, which might augment the current CPN role, within which the nurse might offer not only direct patient care, but also support to members of the primary care team.

Attitude of Health Personnel↗